Individual
DR. LARRY JOE LEVERENZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
800 W STADIUM AVE, DEPT. OF HEALTH & KINESIOLOGY, WEST LAFAYETTE BRA, IN 47907-2046
(765) 494-3167
(765) 496-1239
Mailing address
1210 WESTERN DR, WEST LAFAYETTE BRA, IN 47906-2234
(765) 494-3167
(765) 496-1239
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36000128A
IN
Other
Enumeration date
09/05/2006
Last updated
07/08/2007
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